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Laparoscopic Banding Helps Obese Teens Lose Weight

October 10, 2007 (New Orleans) — Laparoscopic adjustable gastric banding (LAGB) in obese adolescents results in fat mass loss and resolution of most comorbidities, as indicated by preliminary results of a new study presented at the American College of Surgeons 93rd Annual Clinical Congress.

Statistics show that the number of obese children has doubled nationally during the past 20 years. "Studies suggest obese kids carry excess weight into adulthood," said Shivani Reddy, MD, an internal medicine resident at Rhode Island Hospital, and presenter of the study. The study group consisted of teens from 14 to 17 years old who had undergone LAGB since 2005 at the New York University School of Medicine. The teens also had to have been obese for at least 5 years and failed medically supervised attempts to lose weight for at least 6 months.

Data collected at baseline and at 1-year follow-up were compared. Average age pre-operation was 16.1 ± 1.1 years. Weight loss ranged from about 36 to 45 kg, and percentage of excess weight loss averaged 48% (percentage loss calculated on total excess weight). After 1 year, BMI, fat mass, lean mass, and android fat loss (android/visceral fat is most commonly associated with comorbidities of obesity and early death) were all significantly decreased.

The data also showed that LAGB at 1 year in selected obese adolescents is associated with resolution of two thirds of comorbidities and improvement in 10 of 77 comorbidities, in particular dyslipidemia, hypertension, and musculoskeletal problems.

Further follow-up is necessary to ensure that lean mass loss levels off concurrently with overall weight loss, so that overall health status is preserved. The prospective study will continue for 5 years, with a follow-up annually.

Timothy Kane, MD, assistant professor of surgery at the University of Pittsburgh Medical Center, Pennsylvania, commented, "The laparoscopic band is probably the most prudent [bariatric surgical] approach for teenagers, but they are a difficult group for follow-up and compliance..."

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